More than 80 percent of Iowa voters are concerned about the high cost of prescription medicines, and more than a quarter say they have not filled prescriptions or taken drugs as prescribed because of the cost.

The survey was conducted for the West Health Institute, a nonpartisan, nonprofit health care research organization.

The poll also found dissatisfaction with the way President Donald Trump and both parties in Congress are handling the cost of prescription drugs, which West Health Institute sees as a key campaign issue in the Nov. 6 midterm elections.

“In this polarized political environment, rarely does an issue cut across party lines so strongly,” said Shelley Lyford, president and CEO of the West Health Institute. “This poll shows all Iowans are fed up with the high cost of drugs and will reward candidates who support common-sense solutions, like allowing Medicare to directly negotiate prices with drug companies. Voters have told their candidates what they want them to do. Now it’s up to the candidates to make it a priority issue.”

The survey found 64 percent of all Iowa voters — regardless of party affiliation — believe reining in high prescription drug costs should be a top priority for candidates running for Congress. Nearly nine in 10 (86 percent) believe allowing Medicare to negotiate directly with drug companies is the best approach to lowering prescription costs.

Two-thirds said they would be more likely to vote for a candidate who supports this approach.

“Health care is not working for folks. It’s too expensive,” according to Finkenauer, who wants to add a public option to the Affordable Care Act allowing people to buy into Medicare before they are 65.

In the past, she’s said, “What I see working best is Medicare for All. I think that is something we have to get to.”

In the meantime, Finkenauer has called for building on the ACA “and allow our Medicare to be able to negotiate with prescription companies to lower the cost of prescription drugs.”

Blum, too, would allow Medicare to negotiate drug prices and is interested in other options, including allowing the importation of FDA-approved drugs.

“I have consistently supported common-sense measures to lower the cost of prescription drugs, (which) have skyrocketed, and many Americans cannot keep up with these increases,” Blum said.

Blum has introduced the Prescription Drug Price Transparency Act, which would require greater transparency from pharmacy benefit managers, who are the middlemen between the manufacturers, insurers and pharmacists.

In addition to lowering the cost, Blum said, “more transparency in this process will ensure we protect our community pharmacies and the Iowans they serve.”

The survey found 60 percent of Iowa voters believe the cost of health care is the single most important issue facing the country — even more important than jobs and the economy (44 percent), immigration (28 percent) and national security concerns (26 percent).

That’s different from what national surveys have found this summer and fall.

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In September, voters told Gallup dissatisfaction with government and poor leadership was the top concern for 29 percent while health care was the top issue for 3 percent.